Individual research recommendation details

Recommendation ID

CG151/5

Question

Switching from inpatient intravenous to outpatient oral antibiotic therapy in patients with neutropenic sepsis:- A randomised controlled trial should be undertaken to evaluate the clinical and cost effectiveness of stopping intravenous antibiotic therapy and switching to oral therapy within the first 24 hours of treatment in patients with neutropenic sepsis who are having treatment with intravenous antibiotics. The outcomes to be measured are overtreatment, death, need for critical care, length of hospital stay, duration of fever and quality of life.

Any explanatory notes
(if applicable)

Why this is important:- Moderately strong evidence was found to support the use of outpatient therapies for patients with neutropenic sepsis who are at low risk of severe infection. These studies switched from inpatient to outpatient treatment at a variety of time points. A meta-regression undertaken by the Guideline Development Group suggested that very early (before 24 hours) discharge is associated with a greater risk of readmission and need to change treatments, but the evidence was sparse. If a short period of hospital admission was found to be safe and effective for selected patients with neutropenic sepsis, it could provide considerable improvements in their quality of life and reduce the resource burden on hospitals.

Source guidance details

Comes from guidance

Neutropenic sepsis: prevention and management in people with cancer

Number

CG151

Date issued

September 2012

Other details